Surgical mesh prostheses provide support for organs and other tissues during surgery. Surgical mesh prostheses can be used in a variety of applications, such as urinary incontinence slings, breast supports, chest wall closures, elastomeric device reinforcements, wound dressings, vascular anastomosis reinforcements, but perhaps the most common application of a surgical mesh prosthesis is for use during surgical hernia repair.
A hernia is a protrusion of a tissue, structure, or part of an organ through the muscle tissue or membrane by which it is normally contained. Inguinal hernias are one common type of hernia. In an inguinal hernia, a weakness in the abdominal wall grows into a hole, or defect, that may extend into the inguinal canal of the groin region. Tissue, such as fat or small intestine, protrudes from the defect in the abdominal wall. Other example hernias include ventral hernias, which involve an abnormal outpouching through some portion of the abdominal wall, umbilical hernias, in which intra-abdominal contents protrude through a weakness at the site of passage of the umbilical cord through the abdominal wall, and incisional hernias, which occur in an area of weakness caused by an incompletely-healed surgical wound. Those of skill in the art will appreciate that there are other types of hernias in addition to those specifically mentioned herein.
In order to treat a hernia, such as a ventral hernia or an inguinal hernia, a doctor may insert a specially designed hernia repair mesh prosthesis into an incision near the anatomical defect. Implantable prostheses for repairing anatomical defects in tissue or muscle walls typically are designed to be larger than the defect so as to ensure adequate coverage of the defect and/or sufficient fixation of the prosthesis to tissues surrounding the defect. During implantation, the prosthesis is folded and/or pushed through the surgical incision. In order to allow the prosthesis to be positioned properly, the prosthesis may include positioning straps, portions designed for suturing to the surrounding environment, and/or portions designed for fixation via in-growth of surrounding cells into the prosthesis. Once deployed, the prosthesis unfolds and is maneuvered into a suitable position. The positioned prosthesis is then secured by permanent mechanical fixation. For example, permanent mechanical fixation can include suturing the positioning straps to the margins of the defect, suturing a part of the body of the prosthetic mesh patch to the connective tissue or margins of the defect, and allowing natural in-growth of scar tissue to occur. Excess material, such as excess material on the positioning strap, can be removed before the surgical incision is closed by the surgeon.
In procedures using surgical mesh prostheses, a considerable amount of time is spent measuring and marking both the patient and the mesh prosthesis in an effort to ensure the permanently fixed mesh prosthesis is centered over a defect. For example, in surgical hernia repair, the prosthesis may be pre-sutured prior to inserting it into the abdominal cavity, and the sutures pulled out through the abdominal wall in order to place the surgical mesh prosthesis using the measurements and markings created previously. The combination of these preliminary procedures can add in excess of 30 minutes to the procedural time of the surgical hernia repair.
One approach to minimize the amount of time spent measuring and marking a patient and the surgical prosthetic mesh to ensure proper placement over a tissue defect is to use a mesh prosthesis that contains a self-adhering coating, which is typically applied to the mesh prosthesis prior to sterilization and packaging. However, this approach suffers from several drawbacks. For example, the effectiveness of such coatings can be compromised during the sterilization and packaging processes. In addition, self-adhering coatings comprise synthetic glue, and can cause the surgical mesh to adhere to a tissue defect with such strength that the mesh prosthesis cannot be repositioned to properly cover a tissue defect without first removing the mesh and damaging the tissue adhered to the mesh. Thus, there exists a need for a method of implanting or positioning a surgical mesh against a tissue that minimizes the amount of time spent measuring and marking the patient and mesh while enabling an improperly positioned mesh to be repositioned without damaging the tissue.